Reporting on Opioids, Across the Rural-Urban Divide

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Lunch on a vacant loading dock near the St. Vincent de Paul Free Dining Facility, one of the few places in Eureka, Calif., where the police let homeless people congregate.CreditMax Whittaker for The New York Times

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In Eureka, Calif., Steve Shockley explained earlier this year that many homeless people in the region, like himself, shoot heroin during the day for relief. Then they use meth at night to stay awake, he said, because they have nowhere to sleep.

In Brooklyn last winter, Jonathan Roman recounted how employers took advantage of him, knowing he was desperate for money. His dealer used to pick him up after work on payday and take him straight to the ATM.

In Frenchburg, Ky., on the first day of spring last year, Wendy Collins fought back tears as she said that 30 of her friends had died from opioid overdoses.

I’ve traveled all over the country in recent years as a national correspondent and political reporter with the goal of hearing from people and vulnerable communities who feel abandoned or left behind. Along the way I have spoken to a lot of people about heroin and painkiller addictions.

Distance, I’ve learned, isn’t the only barrier we have to cross in writing about this crisis. It can be even harder to cross conceptual ones, to think beyond stereotypes and the stories we have already written.

I have agonized over the fear that my questions are too intrusive. But more often than I would expect, people aren’t just willing to talk about their struggles — they seem to need to talk about their experiences, to hear that their stories matter and that someone cares enough to ask.

I recently moved to Los Angeles as a new California correspondent on the National desk, and I am still exploring the various ways California is like an entire country unto itself. The drive to Eureka for a recent story in Humboldt County reminded me more of driving through rural Appalachia or parts of Alaska, where I grew up. The drive was supposed to take about five hours from Sacramento, each way. It took me closer to six or seven hours. Whole stretches of the twisty State Route 299 — through the Shasta-Trinity National Forest — look over enormous gorges but lack guardrails. (And I’m afraid of heights.) A wild March snowstorm on the way back slowed me down further. There was no cellphone reception, but on the radio I learned that sections of the road were being closed behind me because of dangerous conditions. It was beautiful, but terrifying.

Going to Humboldt County took me in directions I didn’t expect. I was there to talk about heroin, but every person in the community also wanted to talk about homelessness and needle litter. Methamphetamine abuse and the struggling economy were never far away from the conversation either. I had no idea, from the opioid death data I was viewing, that these public health crises had collided in such a way.

Late last year, I began to dig into the surge of opioid-related deaths in the Bronx, which had not received significant attention in the mainstream press but has devastated the borough. The Bronx is just a subway ride north of Manhattan, but is an entire world away in many people’s imaginations. When I first started looking into the community’s struggles with opioids, several people assured me that the Bronx had always had a problem with heroin and that it wasn’t surprising.

The story was much, much more complicated. Certainly there was a long history of drug use in the Bronx, but opioid-related deaths were in fact on a downward trend until a shocking and persistent increase at the beginning of the decade.

What was behind the rise? A pipeline of cheaper, stronger heroin entering the United States; a surge of supply in the Bronx, where many more people were becoming addicted; and the emergence of the powerful synthetic opioid fentanyl in the drug supply. Community activists and leaders were desperate for help but struggled to get much compassion or attention.

Adriana Pericchi, a community health worker, said something to me while sitting at a McDonald’s that I thought spoke eloquently to the shared despair wrought by opioids across all types of communities.

“A lot of us are doing our best, but it’s just not enough, it’s not enough,” she said. “You’re mourning for one particular person who you knew and loved. And really quickly that avalanches into mourning for the state of the city, the state, the country.”

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